What You Need to Know Sugar, Carbs & Sodium. Lisa Brown, RD,LD,CDE BrownFox Solutions, LLC October 30, 2010

Transcription

1 What You Need to Know Sugar, Carbs & Sodium Lisa Brown, RD,LD,CDE BrownFox Solutions, LLC October 30, 2010

2 Diabetes in Youth Most common disease in school aged children 186,300 youth in 2007 have diabetes Type 1 was leading cause of diabetes in children 15,000 new US youth diagnosed a year in SEARCH for Diabetes in Youth Study Group: Incidence of Diabetes in Youth in the United States. JAMA 2007; 297 (24):

3 Diabetes in Youth Type 2 increasing with increase in obesity 3,700 new diagnosis a year in Estimated that 50% of all new diagnosis are Type 2 Highest rates with minority populations American Diabetes Association: Clinical Practice Recommendations - Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 2008; 31(Suppl. 1): S55-S60.

4 Diabetes in Schools Children need to manage their diabetes at school as they do at home. Each student will have different needs. Type 1 & Type 2 have different needs.

5 Diabetes Type 1 Nutrition Management Physical Activity Blood glucose testing Insulin administration Avoidance of hypoglycemia Type 2 Nutrition Management Increased Physical Activity Blood glucose testing Oral medications or Insulin administration Weight reduction

6 Your Role Controlling portion sizes Making healthy food choices Whole grains Fruits & Vegetables Low fat dairy Water Including activity 60 minutes a day No Single Plan - Individualize

7 Carbohydrates Grains, starchy foods peas, corn, potatoes Fruits Milk Yogurt Sugar Read labels for grams of Total Carbohydrates If using choices - 15 grams equals 1 carb choice

8 Celiac Disease 1 in 133 Americans have Celiac Disease Fasano A, Berti I, Gerarduzzi T, Not T, Colletti RB, et al. Prevalence of celiac disease in at-risk and not-at-risk groups in the United States: a large multicenter study. Arch Intern Med, 2003;163:

9 Celiac Disease Diagnosis Diagnosis increased 4 fold from Auto immune disease like Type 1 diabetes Adults typically have symptoms for 11 years before diagnosis

10 Treatment Options Only treatment for Celiac disease is FOOD

11 What Can I Eat? 27,000 Gluten Free foods launched since 2006 $4.3 Billion industry over the next 5 years Mintel Global New Products Database The Future of Gluten-Free:Consumer Insight and Public Opportunities

12 All Fruit

13 All Vegetables

14 All Plain Meats

15 Milk-Yogurt-Block Cheese

16 Fats Nuts Butter & Margarine

17 Grains Rice Oatmeal Popcorn

18 What Can t I Eat? Wheat Barley Rye

19 Label Reading 2006 Labeling laws require wheat to be labeled Gluten is not required yet, so read ingredient lists for: barley malt malt flavoring malt vinegar Rye Federal Register, Docket No. 2005N-0279, Food-Labeling: Gluten Free Labeling of Foods. Available at:

20 Cross Contamination Dedicated toaster Squeeze bottles Prepare gluten free first Meat slicers need to be cleaned

21 Your Role Read labels. Prevent Cross contamination. Be positive!!! They can eat!

22 Health Risks with Sodium Increased Blood Pressure/Hypertension Heart Disease Kidney Disease Reducing sodium could prevent more than 100,000 death annually according to Jane E. Henney, MD, chair of the Committee on Strategies to Reduce Sodium Intake at the the Institute of Medicine.

23 Sodium Unhealthy amounts of sodium in our diet Ave intake >3400 mg Dietary Guidelines <2300 mg Encouraged consumers to avoid salt at the table

24 2008 Congress asked Institute of Medicine to reduce sodium intake < 2300 mg/day for 2 years & older < 1500 mg/day for people over 40, black or with high blood pressure. Flavor, Safety, shelf life, functionality, acceptability New York City of Health and Mental Hygiene. Cut the Salt. Get the Facts. The National Salt Reduction Initiative. April Available at Accessed October 2, 2010.

25 Sodium Require new government standards Manufactures & restaurants need to comply Gradually reduce sodium

26 Sodium Institute of Medicine Recommended Strategies Released 4/20/10 Reduce the sodium content of processed food Restaurants/foodservice to reduce salt added to menu items Revisit GRAS status of food additives

27 Institute of Medicine Voluntarily reduce sodium until implementation of mandatory regulations Collaboration to reduce sodium in foods FDA to revisit health claims & labeling Facilitate & sustain reducing sodium in menu items

28 Institute of Medicine Participate in activities in reducing sodium intake Organize a campaign to achieve goals of the Dietary Guidelines for Americans Data in user friendly formats Congress, CDC, USDA need adequate funding

29 Sodium in School Lunch USDA/FNS % in combination entrees 17% in accompaniments 12% in grains 11% in vegetables

30 Your Role Increase local food preparation Decrease processed foods Fresh fruits & vegetables Frozen vegetables Gradual reduction for acceptance with target goal date of 2020

31 Obesity One-third of all children are overweight or obese 17% obese 16% overweight School Meals: Building Blocks for Healthy Children

32 Health Risks Blood Pressure Joint Pain Osteoporosis Diabetes Cancer Heart Disease Lack of self confidence Ridicule Tooth Decay

33 Sugar Average American consumes 2-3 lb a week In the past 20 years we have increased from 20 lbs to135 lbs of sugar per person per year Lacks vitamins & minerals 12 oz can pop =10 teaspoons sugar (~1/4 c)

34 Sugar Limits No specific limit on added sugars because not listed on nutrition labels Believed that the calorie limits will self limit sugar

35 High Fructose Corn Syrup All are interchangeable from a composition, nutritional, metabolic standpoint. Sucrose Invert sugar Honey Fruit Juice Concentrate HFCS White, John. Misconceptions about High Fructose Corn Syrup: Is It Uniquely Responsible for Obesity, Reactive Dicarbonyl Compounds, and advanced Glycation Endproducts? The Journal of Nutrition Supplement; 2009;1219S-1227S.

36 Your Role School lunch will have a maximum calorie level Fruits & Vegetables not interchangeable Must select a fruit or vegetable to be reimbursable Serve ½ c dark green, orange vegetables & legumes Half the grain must be whole wheat Only fat free & low fat milk Zero trans fat for packaged foods